Repeated efforts to repeal and undermine the Affordable Care Act (ACA) have led to growing public awareness of the importance of access to health coverage and accompanying patient protections. Recognition of the important role of the ACA and Medicare, and growing support for Medicaid, have combined to shape public support for expanding health coverage, instead of retracting it.

In recognition of such growing support, on Tuesday, April 30th, the House Rules Committee held a hearing to discuss H.R. 1384, Reps. Pramila Jayapal and Debbie Dingell’s Medicare for All bill. Although the focus of the hearing was not on the current Medicare program, the combined testimony and subsequent discussion gave rise to a powerful indictment of our current health care system, and began an important conversation in Congress about how to fix it.

Ady Barkan, a health care advocate living with ALS who gave particularly compelling testimony at the hearing, noted that “[o]n the day we are born and on the day we die, and on so many days in between, all of us need medical care. And yet in this country, the wealthiest in the history of human civilization, we do not have an effective or fair or rational system for delivering that care.”

Our mission at the Center for Medicare Advocacy is to advance access to comprehensive Medicare coverage and quality health care for older people and people with disabilities. We strongly believe in universal health care – everyone should have access to quality, affordable coverage and care. We also recognize that there are different ways to achieve that goal.

The Jayapal/Dingell Medicare for All bill would create a new program for everyone that would provide much broader coverage than the current Medicare program, with limited or no cost-sharing for individuals. Further, the Medicare for America Act, reintroduced on May 1st by Reps. Rosa DeLauro and Jan Schakowsky, would, among other things, significantly expand current Medicare coverage, cap out-of-pocket spending, and strengthen patient protections – while retaining employer-based insurance. Such expansion of coverage, and reduction or elimination of out-of-pocket expenses, would be considerable improvements over what we have now.

Although the Center strongly supports achieving universal coverage, our primary focus, and the weight of our efforts, is on identifying flaws in and improving the current Medicare program. As an advocacy organization that provides assistance for Medicare beneficiaries, and develops policy initiatives based upon the experiences of real people, our emphasis is on improving Medicare now.

As Dr. Dean Baker from the Center for Economic and Policy Research testified during the House Rules Committee hearing, there are ways to “fix Medicare” – including adding an out-of-pocket limit for beneficiaries in traditional Medicare, incorporating the Part D drug benefit into the core Medicare program, rather than having stand-along prescription drug plans, and stopping overpayments to private Medicare Advantage plans.

These recommendations align with the Center’s recommendations to improve Medicare, contained in the Medicare Platform we issued in December 2018, reproduced below.

Shifting to universal coverage won’t happen overnight. However, there are enhancements to Medicare for all those who are currently eligible that could be realized soon, and that would make it a better vehicle for universal coverage. As Congress debates how best to expand quality health insurance coverage, we urge policymakers to improve Medicare now.

May 2, 2019 – D. Lipschutz

Medicare Platform: Core Considerations for Today & Tomorrow

The Center for Medicare Advocacy works for a comprehensive Medicare program and quality health coverage and care for all people. To accomplish these goals for current and future beneficiaries in the changing health care environment, we seek to:

Improve Medicare for current and future beneficiaries.

Support the development of the best method possible to increase access to quality health coverage and care for the most people.

Medicare Platform to Improve Medicare for all beneficiaries, now and in the future:

Simplify enrollment in traditional Medicare, Part D and Medigap, and ease transitions from other insurances to Medicare

Improve consumer protections in Medicare Advantage

Standardize benefit packages,

Strengthen network adequacy requirements

Strengthen plan oversight

Strengthen marketing protections

Ensure parity between mental health and physical health coverage

Ensure the Medicare appeals system is cost-effective, accessible and fair

2. Reduce Ongoing Barriers to Care

Eliminate the harm of hospital “Observation Status”

Home Health – Ensure access to coverage is actually available for all beneficiaries who meet coverage criteria, ensure access to legally authorized home health aides, resolve conflicts between payment models and coverage laws